radiation exposure?

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Straight_ahead

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Hi sorry I just didn't find the thread using the search button

Being a radiologist or a radiation therapist, are you concerned about being exposed to radiation all the time? I'm asking this because i'm interested in applying to these programs, but sometimes i just get paranoid when thinking about working in such environments.

Does anybody have any input on this matter?

Thanks. 🙂
 
Hi sorry I just didn't find the thread using the search button

Being a radiologist or a radiation therapist, are you concerned about being exposed to radiation all the time? I'm asking this because i'm interested in applying to these programs, but sometimes i just get paranoid when thinking about working in such environments.

Does anybody have any input on this matter?

Thanks. 🙂

As a radiation worker your radiation exposure is closely monitored and heavily regulated. If you exceed the annual dosage, you have to stop what ever it is that is getting you exposed until the next year. Unless you actually decide to do nuclear medicine or IR/INR your exposure to radiation in radiology is minimal.

If you are still paranoid about radiation exposure, you might also exclude yourself from many of the other interesting fields in medicine including Cardiology, Orthopedics, Neurosurgery. These leadfoots make prodigious use of fluoroscope pedal and often have no formal radiation safety training. They end up giving themselves quite a radiation dose not to mention the patient.

The only people in medicine that don't have their exposure monitored are the patients. There is no annual limit to how much radiation a patient can get. With clinicians ordering CTs to look for a condition that in all probability is 1 in 1000 who knows how many patients are walking around with latent cancers related to unnecessary radiation exposure?
 
Hi sorry I just didn't find the thread using the search button

Being a radiologist or a radiation therapist, are you concerned about being exposed to radiation all the time? I'm asking this because i'm interested in applying to these programs, but sometimes i just get paranoid when thinking about working in such environments.

Does anybody have any input on this matter?

Thanks. 🙂

I do all that I can to minimize my exposure. Other than that, I don't give it a second thought now Flouroscopic studies, where you get the most exposure, are being phased out gradually. Even the VIR people are getting less exposure as more angiograms are done via MR or CT.

I said that I didn't give it a thought anymore, but I used to. I've gotten over it. Also, there are many exposures that occur more frequently that you don't even think about as being carcinogens (e.g., peanut butter, plane travel, trace organics in plastic bottled drinking water). Be judicious in exposing patients and yourself to radiation, and you should be fine.
 
Thanks for the input.

I don't mean I'm actually paranoid, but it's legit to be wary of the problem isnt it? and I'm just wondering how people feels about it.

🙂
 
Thanks for the input.

I don't mean I'm actually paranoid, but it's legit to be wary of the problem isnt it? and I'm just wondering how people feels about it.

🙂

Of course it is legit to worry about it, it's RADIATION!

I'm just saying you do what you can to minimmize your (and your patient's) exposure. Also, the exposure concern is either par or even less than every day carcinogen exposures that we do not even give a 2nd thought to.

Yes, I do occasional fluoroscopy. However since carcinogen exposures are cumulative over a lifetime, I have also given up peanut butter (aflatoxins are the most potent carcinogens known to man), I refuse all nonessential dental xrays (some anecdotal association with posterior fossa primary brain tumors), I dont' smoke and don't frequent places where I will be exposed to 2nd hand smoke, I don't tan, and I don't drink water out of plastic bottles.

Frankly, I think if you didn't even take the above precautions like I do, you would be just fine.
 
In language that is not overly-technical, how much radiation exposure is expected with common procedures?

I remember hearing that 1 CT scan equals ?? number of CXRs but can't recall the specifics.
What's is the CXR radiation equivalent of your standard trauma scan?
 
I gave a radiation safety lecture to the Pain Fellows at Emory (PM&R) a few months ago. Many pain docs use fluoro with reckless abandon, totalling as much as 30 minutes of live fluoro time in a single day. Most average 10-15 minutes total time of live fluoro over the course of 10 procedures.

I failed in my lecture- none of them bought leaded eyewear, but they all did start wearing thyroid shields 100% of the time.

Now about those Vascular, Cardiology, and IR guys.....
Still worse than the pain folks.
 
radiation exposure is very serious. those that don't protect themselves are foolish. There is no downside to wearing protective clothing, or glasses other than a little discomfort but i will take a little discomfort over the repercussions of long term radiation exposure
 
Radiation​
NO SAFE DOSE
ˆThere is no safe level of exposure and there is no dose of radiation so low
that the risk of a malignancy is zero˜--Dr. Karl Z. Morgan, dubbed the father of
Health Physics.1
ˆ.there is no safe level of exposure to ionising radiation, and the search for
quanitifying such a safe level is in vain.˜˙Rosalie Bertell, PhD.2
In 1940, several members of the US Committee on X-Ray and Radium Protection
ˆproposed that the [radiation exposure] standard be lowered by a factor of five
in response to the accumulating evidence that ANY amount of radiation, no matter
how small, can cause genetic damage, injuring future generations.˜ Gioacchino
Failla argued against the lowering of the standards saying that ˆif genetic
damage were to be a consideration for standard-setters, then logically no
radiation exposure should be allowed.˜3
ˆ.the human epidemiological evidence establishes˙by any reasonable standard of
proof˙that there is no safe dose or dose-rate.the safe-dose hypothesis is not
merely implausible˙it is disproven.˜ Dr. J.W. Gofman 4
ˆOne thing we should take from this (1991 study of Oak Ridge weapons workers by
Steve Wing, et al.) is that there isn´t any safe level of radiation exposure.˜
Dr. Carl Shy 5.
ˆThe reanalysis (of Hanford worker data) provides no support for the idea
that.there is reduced cancer effectiveness of radiation at low dose levels.˜
Drs. G.W. Kneale and A. Stewart 6.
ˆThere is evidence that single tracks of all types of ionizing radiation can
induce a variety of damage including DNA double-strand breaks which are believed
to be critical lesions in radiation exposure. There is also a body of
experimental evidence that argues against an error-free DNA repair system
operating at low doses of ionizing radiation that might result in a dose
threshold for the induction of gene and chromosomal mutations.˜ MP Little and CR
Muirhead.7
ˆAn important feature of alpha irradiation is that, no matter how low the total
dose to the whole body, a substantial dose of radiation (approx. .5 Gy) is
delivered to an individual cell if it is traversed by a single alpha particle.˜
E Wright 8.
Compiled by Cindy Folkers, Nuclear Information and Resource Service, 1424 16th
Street NW Suite 404 Washington, DC 20036; 202-328-0002; [email protected]
website: www.nirs.org
Works Cited:
1.˜Cancer and low level ionizing radiation˜ The Bulletin of the Atomic
Scientists. September 1978.
2...No Immediate Danger? Prognosis for a Radioactive Earth. Women´s Educational
Press, Toronto, Ontario. 1985: 45. isbn 0-88961-092-4
3 Caufield, Catherine. Multiple Exposures: Chronicles of the Radiation Age.
Harper and Row, New York. 1989: 48. isbn 0-06-015900-6.
4.Radiation-Induced Cancer from Low-Dose Exposure: An Independent Analysis.
Committee for Nuclear Responsibility, Inc. 1990:18-16, 18-18. Isbn
0-932682-89-8.
5 Garloch, Karen. ˆRepeated low radiation doses hike leukemia risk, UNC study
finds.˜ The Charlotte Observer. Wednesday, March 20, 1991.
6 .˜Reanalysis of Hanford Data: 1944-1986 Deaths.˜ American Journal of
Industrial Medicine. 23:371-389 (1993).
7.˜Curvilinearity in the Dose-Response Curve for Cancer in Japanese Atomic Bomb
Survivors.˜ Environmental Health Perspectives. 105 (6): 1505. (1997)
8.˜Chromosomal instability in the descendants of unirradiated surviving cells
after alpha particle irradiation.˜ Proc. Natl. Acad. Sci. USA.95: 5730 (1998).
ACE
P.O. Box 3063
Stowe, PA 19464
[email protected]
 
1. wherever we stand or go, we are exposed to sources of natural background radiation from:
- charged particles from outer space
- decay of natural isotopes in the earth
- inhalation of radon from natural decay processses

The level of this background radiation is variable and there are communities living at higher altitudes and on 'old' rock formations who are exposed to multiples of the level of background radiation that other communities are exposed to. Nevertheless, those populations at higher background levels have not been shown to have an increased rate of cancer.

2. All data on radiation protection is tainted by the problems with the underlying population groups:
- atomic bomb survivors where exposed to considerable levels of incorporation from I131, Cs137 and other uranium split products.
- atomic bomb survivors where also exposed to a country at war and a city burning down.
- Hanford Reach workers where exposed to fairly high levels of radiation/contamination compared with the levels we are talking about today.
- Israeli immigrants radiated for tinea capitis in the 40s where also exposed to various chemical agents considered less than benign today.
- Patients who receive increased numbers of medical imaging studies also have overall more complex medical histories introducing plenty of confounding influences.

3. 'All it takes is one double strand break'
If that was the case, an animals likelihood of developing cancer should be linearly related to the number of cells in its body. That is not the case. In reality, DNA repair mechanisms, the bodies ability to get rid of cells that that don't do their job anymore (e.g. by radiation induced membrane radical damage) and other carcinogenic influences probably dwarf the impact by environmental radiation.


So, the reality is:

- WE DON'T KNOW WHAT CANCER RISK IF ANY LOW DOSES OF RADIATION SUCH AS THE ONES USED IN DIAGNOSTIC IMAGING STUDIES CONFER.
- We DO know that medical imaging if used judiciously improves patient outcomes and is one of the foundations of modern medical and surgical therapy.

As long as we don't know whether we do damage, it is prudent to minimize the exposure to our patients. At the same time, we have to be careful not to withold necessary treatment from patients based on an irrational fear of radiation.

(let me regale you with an anecdote from my clinical practice: one of my FPs had a 6mo old with big noggin and wanted to send the kid for a CT scan. the overeducated mother flat out refused for 3months and only after the kid developed torticollis and a nonreactive pupil, the ophthalmologist managed to convice mom that the kid won't be mentally ******ed from the dose of a single CT scan. suffice to say that at that point, the optic glioma had grown beyond the point of operability.)
 
(let me regale you with an anecdote from my clinical practice: one of my FPs had a 6mo old with big noggin and wanted to send the kid for a CT scan. the overeducated mother flat out refused for 3months and only after the kid developed torticollis and a nonreactive pupil, the ophthalmologist managed to convice mom that the kid won't be mentally ******ed from the dose of a single CT scan. suffice to say that at that point, the optic glioma had grown beyond the point of operability.)


I believe the story. But why didn't they offer the kid an MR? Or was the Mom afraid of magnetic fields too?
 
I believe the story. But why didn't they offer the kid an MR? Or was the Mom afraid of magnetic fields too?
This falls under the "a little knowledge is a dangerous thing" heading. If the mother was scared enough about radiation from CT scans not to sit down and listen to people who have a better sense of the risks and benefits of the procedure, I doubt that she would have had the common sense to learn the risks and benefits of using magnetic fields instead.
 
I believe the story. But why didn't they offer the kid an MR? Or was the Mom afraid of magnetic fields too?

She was afraid of everything. MR was out because it would have required the kid to miss a meal for the sedation (cruel, isn't it?).
 
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